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Hospital Team
(OpenClipart-
Vectors, Pixabay)

Hospital Bed
(Parentingupstream,
Pixabay)

Hospital Baby
(eloisa, Pixabay)

We Can Do It! Doula
(OpenClipart-
Vectors, Pixabay)

Graphic (black & white) of a surgery team in a hospital operating theatre Hospital Birth

For about 90% of women the safest and best place for birth is home.
Birth is not a medical event.
A woman-centric birthing centre is next best.
In other words, for most women a hospital birth is not the Way.
Yet maybe 99% of women opt for it.
Here we explore some history and evidence related to this.
History

'Prior to 200 years ago all birth care around the world was humanized as it was attended by midwives, kept the woman in the center and, in general, respected nature and culture.
After World War II came the technological age. If we can put a man on the moon, surely we can also have perfect birth. So without any scientific data to justify such a move, childbirth was moved to hospitals with doctors and machines and drugs. Midwives were marginalized, with no role for women or family, and birth became medicalized.
In the 1980s and 1990s women began to react against this and began a move to humanized birth. Humanized birth means that the woman giving birth is in the center and in control so that she, and not the doctors or anyone else, makes all the decisions about what will happen. Humanized birth means understanding that the focus of maternity services is community-based primary care, not hospital-based tertiary care. Humanized birth is with midwives — traditional and official, nurses and doctors working together in harmony as equals. Humanized birth means maternity services that are based on good scientific evidence including evidence-based use of technology and drugs.
The past fifteen years has seen an intense and global struggle between medicalized birth and humanized birth. Today three kinds of maternity care exist: the highly medicalized, “high tech,” doctor-
centered, midwife-marginalized care found, for example, in the US, Russia, Eastern European countries and urban areas of developing countries; the humanized approach with strong, more autonomous midwives and much lower intervention rates found, for example, in the Netherlands, New Zealand and the Scandinavian countries; and a mixture of both approaches found, for example, in Britain, Canada, Germany, Japan and Australia.'
(Marsden Wagner,
Midwifery Today, first published 2007, accessed 21 August 2019)

Labouring woman in hospital bed, tubes inserted, tech around

Consider This (Part 1)

'
Are You a Good Candidate for a Hospital Birth?

A good candidate:
  • Must not be scared of needles.
  • Must not be claustrophobic or uncomfortable in confined spaces.
  • Must be able to fast for long periods of time.
  • Must be happy to share one bathroom with six others.
  • Must enjoy sleeping on a mattress covered with rubber or plastic.
  • Must not have a rebellious or questioning nature.
  • Must accept the possibility of contracting antibiotic-resistant infections.
  • Must be confident with caregivers who are overtired and overworked.
  • Must realize that a limited amount of time can be spent in a hospital bed before it is needed for the next patient coming in the door.
  • Must like and trust electrical equipment.
  • Must be comfortable with a cesarean rate of one in four or higher.
  • Must realize that the doctor seen in pregnancy may not be on call at the time of birth.
  • Must accept that the mood of the nurse on duty will be a large determinant of the birth outcome.
  • Must realize that the written birth plan may be ignored.
  • Must be willing to have her partner be treated like an extraneous idiot.
  • Must be willing to have fluorescent lights turned on at all hours.
  • Must be capable of birthing without making loud noises.
  • Must look good in a flimsy blue gown that is open at the back.
  • Must be willing to be a teaching subject for student doctors who are learning to do pelvic exams and suturing.'
(Gloria Lemay, The Birthkit, Number 43, Autumn 2004; accessed online 16 October 2020)

Consider This (Part 2)

‘Ina May recommends the following humor assessment story. “Did you ever notice that you can have a stomach pain and then fart, and you feel better? Imagine if people went to the emergency room to fart?”’
(Kate Prendergast, Midwifery Today, first published 2008, accessed online 10 April 2019)


Consider This (Part 3)

'If you are not planning your birth — meaning you are using the hospital template that’s been prepared for you by institutions, corporations and commercially-funded committees — the odds are extremely high that:
  • When you enter the hospital, you will either be placed in a wheelchair or you will walk to a labor room. You will be hooked up to an IV, one or several monitors and denied food and even beverages (other than ice chips, which in many cultures are considered something to avoid in labor).
  • Depending on how “progressive” the hospital and staff are, you will be allowed or encouraged to walk around and work in different labor positions to encourage the baby into an optimal position and allow labor to progress, or you will simply be advised to stay flat on your back — which is considered by many in the birthing world to be one of the most painful and least effective ways to labor.
  • Around the time you start experiencing stronger contractions and the pain sensations are increasing, hospital staff (strangers) will appear at your door encouraging the use of drugs.
  • You will be checked periodically by doctors, residents, nurses and student nurses (more strangers). When you’re dilated far enough, they will move you to the delivery room where your doctor, or a stand-in if he or she has been called away to more pressing matters, will stay with you as the baby and the placenta are born.
This is all assuming that you’re not put on additional drugs to speed labor (if in their estimation you’re taking too long). While 24 hours or longer is a common length of time for a mother to labor — especially with her first baby — many hospitals encourage drugs to speed the process if it passes 12 hours.
It is also assuming that nothing has happened to encourage the doctor to perform a cesarean (now at 30–50% of births in the US, varying by doctor and hospital).
  • All in all, as Jennifer Block states in her book Pushed: The Painful Truth about Modern Childbirth and Maternity Care, a mother, even in a “routine” birth in a hospital, may have “up to 16 different tubes, drugs or attachments” (Block 2007, xiv).
  • After the baby and placenta are born, in most instances they are both taken away: the baby to be washed (unnecessary and considered by many to be stressful for the newborn who’d rather be on her mother’s chest), weighed, measured and treated with various pharmaceutical products and the placenta to an incinerator.'
(Allie Chee, Midwifery Today, first published 2012, accessed online 11 November 2015)

Baby just delivered in a hospital operating theatre, held aloft by a surgeon

Consider This (Part 4)

Impact on Women on Relocation from Home to Hospital
  • Loss of familiar environment
  • Loss of family support
  • Loss of privacy
  • Loss of dignity
  • Loss of resources
  • Loss of confidence
  • Loss of ability to care for self and baby
(Adapted from research in TEDx talk, 11m4s, posted 17 December 2013, accessed 19 October 2020)

Consider This (Part 5)

'Women today do not believe that their bodies know what to do, much less that their babies also know what to do. Because they are afraid and feel like they lack knowledge, they are often reassured rather than anxious when they enter the hospital. At the conscious level, they believe that all will be well within those walls. They believe this because they trust that someone else will know what to do if something goes wrong. The authority has been transferred to someone outside. But the body doesn't lie, and that is why, despite a feeling of comfort in the hospital, many women still find that their labor slows or stops on admission to the maternity unit. It is also why so many women harbor nagging doubts about the necessity of many of the procedures done—to them and to their babies — in the name of helping. It is why so many women — and most health workers today — do not know the difference between intervention and support.'
(Suzanne ArmsImmaculate Deception II: Myth, Magic and Birth)


Safety

‘...statistics prove that planned homebirth, attended by an experienced midwife, is a safe, economical choice for most women.’
(Judy Edmunds, Midwifery Today, published 1995, accessed 4 March 2020)


Finally

If you choose or need a hospital birth, a supportive doula could be of huge help.
Continuity of care is so important. Prenatally, natally, postnatally.

Graphic saying 'We Can Do It!', and a doula showing she's ready to work with you

Resources:-
Also see:-

Birth Plan

Home Birth


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